A skillful path for cancer


A few years ago I had a rapidly growing lump under my left arm. Having worked for over 20 years in oncology, palliative care and palliative care, my rapidly growing tumor was a cause for fear and concern. My parents had cancer four times between them, so I’ve known for years that I have a genetic risk for cancer. As soon as I noticed the growth under my arm, I immediately made an appointment with a trusted family doctor.

During my appointment, as my doctor was examining my potentially cancerous tumor, he sadly remarked, “Only the good die young. I don’t know what he meant by that, but I didn’t find it comforting.

There are over 200 types of cancer, and the experience of having cancer can be drastically different for each individual. What tends to be true for the vast majority of cancer patients and caregivers is that cancer is difficult.

It’s hard to describe the strange new world of being diagnosed with cancer. Often, at the beginning, people are in a state of shock. It can be difficult to recognize, even on a purely rational and factual level, that you have cancer. It is difficult for the brain to process this new seminal reality. A cancer diagnosis is often the first time many people are forced to face their mortality directly in a realistic way, and it can be shocking.

Many cancer patients have told me that it takes a few months to overcome the numbness and shock of a cancer diagnosis before they can begin to process their emotions and adjust to the magnitude of the changes brings cancer.

One thing that often surprises people is the complexity of cancer. Patients and families are faced with a bewildering array of treatment options with far-reaching consequences and often with little time to think through the ramifications of their choices.

In his book “Being Mortal: Medicine and What Matters in the End”, Dr. Atul Gawande describes what it was like when his own father was diagnosed with cancer. Gawande is both a surgeon and a professor at Harvard Medical School, and his parents were also doctors. A family of doctors seems to be the ideal family to care for a loved one with cancer. However, Gawande explains that despite the fact that all three of them were doctors, none of them understood their treatment options because they were not specifically oncologists. In other words, modern medicine has become so complicated that being a doctor is not always enough training to fully decipher and deal with cancer-related treatment options. If a family of doctors doesn’t understand what their oncologist is telling them, how well does the average patient actually understand their cancer treatment?

Cancer is also expensive. Ask any patient with newly diagnosed cancer what one of their biggest fears is and they will usually respond that they are worried about medical expenses. Former professional athlete Lance Armstrong has described how cancer could have bankrupted him if his insurance had been canceled, which almost happened to him, and he is a multi-millionaire. It’s not hard to imagine what cancer treatment can do for most people’s finances. What kind of toll does it take on his sanity to internally debate cancer treatment or bankruptcy? Medical bills are the leading cause of bankruptcy in the United States. Medical bills leading to bankruptcy are particularly problematic in Texas, which has the highest rate of uninsured patients in the nation.

I remember when my mother had cancer. Sometimes she lay in bed in so much pain and discomfort that she could only shiver and cry silently. My mom cried when her hair started falling out in clumps, a common side effect of chemotherapy. Being a caregiver can be just as difficult. When a loved one is diagnosed with a chronic or incurable disease, caregivers can sometimes have a shorter life expectancy than the patient. For patients and their family members, the psychological challenges of cancer are often the most difficult. Many cancer patients and caregivers have weakened immune systems, and the COVID-19 pandemic has been particularly difficult for the oncology community.

This is why I am so grateful to the Flatwater Foundation (flatwaterfoundation.org). The Flatwater Foundation provides mental health services through licensed providers (psychologists, social workers, licensed professional counselors, etc.) to cancer patients and family members who would otherwise not have access to support in mental health. The Flatwater Foundation was founded by Mark Garza after he struggled to find affordable mental health support for his family when his father was diagnosed with stage IV cancer.

The Flatwater Foundation provides mental health services to cancer patients and their family caregivers in central Texas; they connect individuals with professional therapists to help provide support and find the strength to accept a cancer diagnosis. Since its inception in 2010, the Flatwater Foundation has raised over $7.5 million and paid for over 54,000 hours of therapy for those who otherwise could not afford mental health care.

There are a lot of stressful things going on in our society. But something I think we can all support is providing quality mental health support to cancer patients and their family members who could not otherwise afford it, especially when so many are struggling to access taking care.

More good news, if you want to do something to help make a real difference in your community, you have a great opportunity. On Monday, September 12, the Flatwater Foundation will host its annual fundraising event: Tyler’s Dam That Cancer. Participants riding stand-up paddleboards complete a 21-mile course from Lake Austin’s Mansfield Dam to Tom Miller Dam. This year, 230 paddlers signed up for the event, seeking to raise $1.2 million to benefit the foundation’s mission to provide mental health therapy in the form of counseling sessions to Central Texans affected by the cancer. To date, this annual event has raised over $5 million for families affected by a cancer diagnosis.

I have seen the trauma that a cancer diagnosis can inflict. And I have also seen the hope, determination, growth and grace of cancer patients and caregivers, which amazes me on a daily basis. If you are interested in participating and supporting Tyler’s Dam That Cancer, please visit tylersdtc.com.

There are difficult things in the world, and there is also joy and transformation. The historical Buddha said that community is the most important part of the spiritual path. I can’t think of a more skillful community and vision than the Flatwater Foundation, and this Buddhist monk offers the Flatwater Foundation my heartfelt greetings of gratitude.

Dr. David Zuniga is a clinical psychologist in private practice in Austin, and he is also a vice-bishop in one of the oldest lineages of Korean Zen; his website is a free, cross-disciplinary source of support: drdavidzuniga.com.

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